One cynical mirage that serves as a cornerstone in the grand illusion of the American welfare state is the belief that the US economy has produced an altruistic health care system serving the needs of its clients. This ideological chimera has recently bee n called into question to the extent that some reforms may be passed on Capitol Hill in an attempt to pacify the discontented; however, it seems extremely unlikely that the multi-billion dollar health care system, a century in the making, will be cleansed of its criminal intent by some new health care packages. "Criminal" is certainly the word that best describes the health care system in the United States. The leaders of organized crime could not have thought of a better method of extortion on their best day. Since life itself is of the greatest value-biologically and culturally-that which extends life also becomes of the highest value. Unlike most commodities, the services and products of the health care system are essential to everyone at some point. It is therefore known that the client can and must pay whatever rate is demanded (rates that would defy the wildest imaginations of loan sharks). Refusal to comply is punished by death.What makes this extortion racket so beautiful in its efficiency is tha t it requires no muscle; the punishment generates by itself through inaction. Proper due should be given to the professionals of the health care system; they are, after all, kind enough to offer just-in-time treatment. When a health problem is so bad that it becomes an emergency, a client will be admitted to a state hospital free of charge on a triage basis, but under the assumption that the client will not be around long enough to do it too often. (With such kindness it would not be at all surprising if different components of the medical establishment sponsor little league teams too). 36 million people, either working families or the completely disenfranchised underclass, have no choice but to use this procedure. It does have a function for the system: It keeps up the panic level in those who are willing to pay their pr otection money to the medical syndicate (coalitions of medical professionals, hospitals and medical care facilities, insurance companies, and pharmaceutical companies). Any syndicate willing to cap 36 million men, women, and children without a second thou ght has to instill fear in everyone. Next to this bunch, the Mafia is a group of gentleman. If you do not want to be among this obscene number with a contract on your head, show some respect-work your job and pay the money. And it better be paid on time!